Not the enemy: superficial subcutaneous adipose tissue may bring protective benefits

Abstract

Subcutaneous adipose tissue (SAT) has been suggested to be a protective fat depot. Measurement of skinfold thickness (ST) is a simple means of superficial SAT (SSAT) assessment, but its correlation with mortality risk is controversial. We aimed to investigate the association between ST measured at 4 commonly assessed sites and the risk for all‑cause, cardiovascular (CV), and cancer mortality. A total of 10 261 eligible individuals aged 20 to 90 years who participated in the National Health and Nutrition Examination Survey III were included. Hazard ratios (HRs) for all‑cause, CV, and cancer mortality were examined for 4 sites of ST measurement: the triceps, subscapular and suprailiac regions, and the thigh. Receiver operating characteristic analysis was performed to determine the predictive ability of ST for mortality risk. All 4 STs were associated with a lower risk for mortality, with an HR below 1. Among the 4 sites, suprailiac ST had the greatest protective benefit in terms of all‑cause mortality (HR, 0.972; P <0.001) and CV mortality (HR, 0.562; P <0.001), and was the best predictive factor for all‑cause mortality (area under the curve = 0.576; P <0.001). In subgroup analyses, men and elderly patients (≥65 years old) manifested protective effects of SAT at more sites and with respect to more causes of mortality. The inverse association between ST and mortality risk implies possible benefits of SSAT in terms of mortality risk reduction. This effect was especially notable for ST measured at the suprailiac region.